Until I watched Excision, the controversial horror/drama/comedy from first-time director Richard Bates Jr., I had no idea who AnnaLynne McCord was. A cursory search online revealed an extremely hot young actress whose main claim to fame is a role on what appears to be some sort of Beverly Hills 90210 revival. If the previous incarnation of said series taught me anything, it’s that the bulk of the actors and actresses who’ve appear on these sorts of shows aren’t exactly Lee Strasberg graduates, so color me pleasantly surprised when it turns out that not only does the lovely Mrs. McCord possess some serious acting chops; she’s also one brave little lady when it comes to throwing herself into a role that would probably challenge even the most seasoned of thesps.

McCord stars as Pauline, a deeply troubled social misfit whose sense of smug superiority is matched only by her poor personal hygiene. Hated by her schoolmates and barely tolerated by her own parents, (a fantastic Traci Lords as her overly critical mother, Phyllis, and Hostel’s Roger Bart as her put-upon father, Bob), Pauline soldiers on through a world she finds increasingly less stimulating and challenging, retreating into gory, sexually charged fantasies, and pouring over medical texts, intent on becoming a surgeon despite the fact that she’s barely getting by in school. The only thing other than herself that Pauline shows any compassion for is her sister, Grace (Ariel Winter) – a pretty, popular young teen who suffers from Cystic Fibrosis, but, even then, Pauline’s interactions with her sister seem to be less about sisterly love and more a byproduct of Pauline’s ghoulish fascination with the sick and dying.

Phyllis, who expects nothing but perfection from her daughters, tries to socialize Pauline, but, with every little push, Pauline violently shoves back until, finally, the girl’s carefully constructed façade caves in around her, culminating in shocking conclusion in which Pauline, suddenly eager to please her mother, does the unthinkable.

As I watched Excision, I couldn’t help but think of a trio of very dissimilar films; Pascal Laugier’s Martyrs, Richard Kelly’s Donnie Darko, and…well… Napoleon Dynamite. I know, I know; it sounds like a strange combination, but, tonally, the film is very similar Kelly’s classic mindfuck, while the elegantly shot and highly stylized dream sequences called to mind the clinical aesthetic of Martyrs. As for my Napoleon Dynamite comparison, well, Pauline is a lot like Napoleon (sans the squinty eyes and moon boots). She’s socially inept and almost universally reviled yet, rather than attempt to connect with those around her, she pushes them further away with her attitude, actions, and unkempt appearance. She’s a thoroughly delusional narcissist, seemingly unaware of the way the world actually sees her. This is reflected in her fantasies, where she sees herself as this ethereally glamorous and regal being, performing bizarre surgical procedures whilst writhing around half-naked on a sea of orgasmic, gyrating flesh.

McCord is absolutely fearless in the role, doing things that most young actresses would rightly be repulsed by, and playing a character that is patently unsympathetic and downright uncomfortable to watch. With Pauline, we are witnessing the formative years of a psychopath, and McCord unapologetic in her portrayal of such. Lords, meanwhile, truly surprises with one of her most accomplished performances to date. Lords has always been a passable actress, but she’s improved quite a bit over the years, and, here, proves that she not only belongs in front of the camera, but deserves a shot at bigger and better roles, porn star past be damned. Rounding out the great performances, John Waters turns in a terrific cameo as a priest who serves as a therapist for Pauline. Waters reactions to Pauline’s heretical remarks are priceless, especially when one considers that this is the man who once had an overweight transvestite imbibe feces on film.

Excision alternates between darkly comedic and stomach churning, with a final, thoroughly disturbing scene that will stick with the viewer for days. It’s a really impressive movie; one that, much like the aforementioned Donnie Darko, defies categorization, and, like Kelly’s film, seems primed for cult status.

Excision comes to Blu-ray courtesy of Anchor Bay, and is presented in a 2.40:1 1080p transfer. The image is crisp and clean, with an abundance of fine detail throughout. The film has two distinct palettes; the somewhat drab, muted colors of Pauline’s real world, and the vibrant, ultra-high contrast hues of her fantasies, where the image really pops. The 5.1 True HD track is equally impressive, with clear dialogue, rich bass, and a nicely scattered and sonically separated mix.

The Blu-ray features only one extra – a single commentary track – but it’s a good one, featuring a very engaging McCord and Bates Jr. discussing the film, the character of Pauline, and offering a lot of funny and informative nuggets about the production.

I’d heard a little bit about the controversial nature of this film prior to seeing it, but I usually find this all to be so much hype. Excision is an exception, however, as it really can be a difficult and uncomfortable film to watch at times. It’s certainly not for everybody, but if you’ve the stomach for it, you’ll be rewarded with a brilliantly acted, elegantly crafted, and truly unique film that will stick with you for the long haul. Highly recommended.